The effects of pulmonary diseases on histologic types of lung cancer in both sexes: a population-based study in Taiwan

Abstract

BackgroundThe associations between pulmonary diseases (asthma, chronic obstructive pulmonary disease [COPD], and tuberculosis [TB]) and subsequent lung cancer risk have been reported, but few studies have investigated the association with different histologic types of lung cancer.MethodsPatients newly diagnosed with lung cancer from 2004 to 2008 were identified from the National Health Insurance Research Database in Taiwan. Histologic types of lung cancer were further confirmed using the Taiwan Cancer Registry Database. Cox proportional hazards regression was used to calculate the hazard ratio (HR) of asthma, COPD, and TB and to estimate the risk of specific types of lung cancer.ResultsDuring the study period, 32,759 cases of lung cancer were identified from 15,219,024 insurants aged 20 years and older. In men and women, the adjusted HR estimates of squamous cell carcinoma were respectively 1.37 (95 % confidence interval [CI], 1.21–1.54) and 2.10 (95 % CI, 1.36–3.23) for TB, 1.52 (95 % CI, 1.42–1.64) and 1.50 (95 % CI, 1.21–1.85) for asthma, and 1.66 (95 % CI, 1.56–1.76) and 1.44 (95 % CI, 1.19–1.74) for COPD. Similarly, the adjusted HR estimates of adenocarcinoma were respectively 1.33 (95 % CI, 1.19–1.50) and 1.86 (95 % CI, 1.57–2.19) for TB, 1.13 (95 % CI, 1.05–1.21) and 1.18 (95 % CI, 1.09–1.28) for asthma, and 1.50 (95 % CI, 1.42–1.59) and 1.33 (95 % CI, 1.25–1.42) for COPD. The HRs of small cell carcinoma were respectively 1.24 (95 % CI, 1.01–1.52) and 2.23 (95 % CI, 1.17–4.25) for TB, 1.51 (95 % CI, 1.35–1.69) and 1.63 (95 % CI, 1.16–2.27) for asthma, and 1.39 (95 % CI, 1.26–1.53) and 1.78 (95 % CI, 1.33–2.39) for COPD.ConclusionsAsthma, COPD, and TB were associated with an increased risk of all major subtypes of lung cancer. The risk was the highest among women with TB.

Epidemiology and Survival Outcomes of Lung Cancer: A Population-Based Study

“…Most women with lung cancer are nonsmokers, however, and the incidence of lung adenocarcinoma became increasingly predominant, especially in the Asian population [9]. Indoor and outdoor air pollution has been deemed as a significant contributor for lung cancer, especially for lung adenocarcinoma and female patients; additionally, it might play a role in the observed urban-rural disparity of lung cancer in Taiwan [26].…”

“…e occurrence of lung cancer has been reduced through tobacco control such as increasing tobacco taxes and prices, health warnings on packages, and advocating smoking cessation, as well as through comprehensive ban on tobacco advertising [1]. On the other hand, adenocarcinoma is more common in the Asian population, particularly among females and never-smokers [5,9]. Robust data exist regarding the prevalence of EGFR mutations in adenocarcinoma patients, ranging from the highest EGFR mutation frequency of 47% in the Asia-Pacific subgroup to the lowest frequency of 12% in the Oceania subgroup [10].…”

The use of corticosteroids in patients with COPD or asthma does not decrease lung squamous cell carcinoma

“…Taiwan’s National Health Insurance covers more than 99 % of the 23 million residents and contains enrollment files, claims data, catastrophic illness files, and registry for treatments. The database is one of the largest datasets described in most epidemiological studies [ 13 – 15 ]. This study used multiple databases: the NHIRD, Taiwan Cancer Registry Database (TCRD), and National Death Registry Database (NDRD) with permission of the Department of Statistics, Ministry of Health and Welfare of Taiwan.…”

snoRNA and piRNA expression levels modified by tobacco use in women with lung adenocarcinoma

“…However, most smokers do not develop lung cancer while 20% of women with lung adenocarcinoma are non-smokers [ 8 ]. Therefore, other factors than smoking status may contribute to the development of lung cancer [ 9 ].…”